US20140163566A1 - Devices, methods and systems for affixing an access device to a vertebral body for the insertion of bone cement - Google Patents
Devices, methods and systems for affixing an access device to a vertebral body for the insertion of bone cement Download PDFInfo
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- US20140163566A1 US20140163566A1 US13/841,380 US201313841380A US2014163566A1 US 20140163566 A1 US20140163566 A1 US 20140163566A1 US 201313841380 A US201313841380 A US 201313841380A US 2014163566 A1 US2014163566 A1 US 2014163566A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
- A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
- A61B17/8822—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by means facilitating expulsion of fluid from the introducer, e.g. a screw pump plunger, hydraulic force transmissions, application of vibrations or a vacuum
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
- A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
- A61B17/8811—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by the introducer tip, i.e. the part inserted into or onto the bone
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
- A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
- A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
- A61B17/8808—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it with sealing collar for bone cavity
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8802—Equipment for handling bone cement or other fluid fillers
- A61B17/8805—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it
- A61B17/8816—Equipment for handling bone cement or other fluid fillers for introducing fluid filler into bone or extracting it characterised by the conduit, e.g. tube, along which fluid flows into the body or by conduit connections
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- Orthopedic Medicine & Surgery (AREA)
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- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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Abstract
Description
- This application is a non-provisional Of U.S. Provisional No. 61/736,522 filed Dec. 12, 2012, the entirety of which is incorporated by reference.
- Posterior fixation as is commonly used to help stabilize the treated spine constructs for various degenerative and traumatic spine conditions and can also be an adjunct to interbody fusion.
- Posterior fixation often includes the use of a pedicle screw and rod system, where the pedicle screw is anchored into a vertebra pedicle and vertebral body. A rod is then attached between heads of at least two adjacent pedicle screws that are located ipsilaterally on the pedicle or vertebral body. This configuration helps to immobilize the treated spine construct and aid in the interbody fusion. In instances where the bone quality is poor the pedicle screw can loosen after surgery, requiring a revision surgery to replace or re-stabilize the loosened screw.
- To address the anchoring problems of pedicle screws in poor quality bone, surgeons have been placing bone cement (PMMA) into the vertebral body and pedicle, then placing the pedicle screw within the bone cement. Once cured, the cement acts as a foundation for the pedicle screw allowing it to he securely anchored within the vertebral body and pedicle.
- There remains a need for methods and instruments that can safely access the pedicle and deliver bone cement via a minimally invasive surgery (MIS) that can also work in conjunction with the various MIS techniques and instruments used for pedicle screw and rod fixation.
-
FIG. 1 shows a first variation of an access instrument for use in applying cement as described herein. -
FIGS. 2A to 2C illustrate the working end of the access device shown inFIG. 1 . -
FIGS. 2D and 2E illustrate additional variations of ramp-like features. -
FIGS. 3A and 3B show cross sectional views of the access device shown inFIG. 1 to illustrate the mechanism that permits advancement and retraction of the middle tube. -
FIG. 4 shows another variation of an access device. -
FIG. 5 illustrates a state of the device ofFIG. 4 where the stylet knob is removed from the device. -
FIGS. 6A and 6B illustrate the state of the access device ofFIG. 4 where the shuttle knob is used to withdraw the outer tube. -
FIG. 7 shows another variation of a working end of a device. -
FIGS. 8A to 8K illustrate an example of a surgical technique to apply bone cement to a site where the bone cement assists in anchoring of an implant such as a pedicle screw. -
FIG. 8L shows an example of positioning implants within pilot holed filled with bone cement as discussed herein. - The present disclosure includes devices and methods for device for delivering a pressurized substance to an opening in bone within a vertebral column. Any of the devices and method used herein can be used for applications on or in the vertebral column (e.g., vertebral bodies, the sacrum, the coccyx, etc.) Additional variations of the device and methods allow for use anywhere in bone or other hard tissue.
- In one example, a variation of a medical device described herein includes a handle portion having a proximal port; an inner member coupled to the handle portion and having a proximal end and a distal working end; a working lumen extending through the inner member; a bone engaging section located about a distal portion of the inner member, the bone engaging section configured to expand radially away from the inner member and maintain an expansion three against the opening to prevent dislodgement of the working lumen from the bone; a shuttle member mechanically coupled to the handle portion and the bone engaging section, where actuation of the shuttle member drives the bone engaging section in a radially outward direction.
- In another variation, the device can further comprise an outer member and an intermediate member located between the outer member and inner member, where the bone engaging section comprises a slotted distal portion of the intermediate member.
- Another variation includes a medical device further comprising a radially offset surface located on a distal portion of the inner member, where the intermediate member is coupled to the shuttle member such that actuation of the shuttle member drives the slotted distal portion of the intermediate member over the radially offset surface resulting in divergence of at the slotted distal portion in the radially outward direction.
- The radially offset surface can include any surface that deflects or expands the slotted portion. For example such surfaces can be selected from the group consisting of a ramp, a protrusion, and a collar.
- In an additional variation, the outer member is coupled to the shuttle and where actuation of the shuttle member causes relative movement between the outer member and intermediate member such that when slotted distal portion of intermediate member is exposed the slotted distal portion self-expands in the radially outward direction.
- The slotted distal portion can comprise a plurality of tines and where the outer member causes collapse of the tines onto the inner member upon withdrawal of the slotted distal portion within the outer member. In some examples, the slotted distal portion comprises a plurality of tines where a distal end of the tines extends in the radially outward direction.
- In certain devices a distal end of the inner member is coupled to a distal end of the intermediate member, where the shuttle member is coupled to the inner member and the intermediate member is coupled to the handle portion, where actuation of the shuttle member moves the distal end of the intermediate member relative to the handle portion to cause expansion of the slotted distal portion in the radially outward direction.
- One example of a shuttle member comprises a threaded knob coupled to a threaded hub, where the threaded knob coupled can he coupled to one of the inner member, intermediate member, and the outer member.
- The medical device described herein can further include a stylet extending in the working lumen of the inner tube, where a proximal end of the stylet is releasably coupled to the proximal port. The stylet can further include a guidewire lumen.
- The disclosure also includes methods for delivering a substance to an opening located in a bone of a vertebral column. One variation of the method comprises advancing an access device to the bone, where the access device includes a delivery lumen extending from a proximal opening to a distal port; and positioning an anchoring portion of the access device within the opening in the bone; anchoring the access device to the bone by engaging the anchoring portion against a wall portion of the bone surrounding the opening such that the delivery lumen creates a fluid path from the proximal opening through the distal port and into the opening; and delivering the substance through the delivery lumen into the opening where the anchoring portion prevents rearward movement of the access device from the opening during delivery.
- Variations of the method can include advancing the access device to the bone comprises advancing the access device over a guide wire, where the guide wire is positioned within the opening in bone.
- In another variation, the anchoring portion comprises an expandable structure such that anchoring the access device comprises forcing the expandable structure against a wall of the hole secure the access device within the hole.
- In another variation, the expandable portion comprises a slotted portion of a slidable tube, and where the access device further comprises a radially offset portion, wherein anchoring the access device comprises advancing the slidable tube over the radially offset portion to cause the slotted, portion to expand against the wall portion of the opening.
- Another variation of the method includes where the delivery lumen extends through an inner tube and where the expandable portion comprises slotted portion of a slidable tube located over the inner tube, and where the inner tube is affixed to the slidable tube at a distal location, wherein anchoring the access device comprises moving the inner tube relative to the the slidable tube to cause the slotted portion to expand against the wall portion of the opening.
- The disclosure also includes methods of temporarily securing an access device to an opening within a portion of bone in a vertebral column. For example, such a method can include advancing an access device to the bone, where the access device includes a delivery lumen extending from a proximal opening to a distal port; positioning a working end of the access device into the opening; and displacing an anchoring portion of the access device against a wall of the opening while maintaining the working end within the opening, wherein the anchoring portion mechanically engages the wall of the opening to releasably secure the access device to the opening.
- Another method includes securing an implant within a portion of a bone in a vertebral column. Such a variation can include advancing an access device to the bone, where the access device includes a delivery lumen extending from a proximal opening to a distal port; and positioning a working end of the access device into an opening in the bone; displacing an anchoring portion of the access device against a wall of the opening while maintaining the working end within the opening, wherein the anchoring portion mechanically engages the wall of the opening to releasably secure the access device to the opening; delivering a bone cement through the delivery lumen into the opening; disengaging the anchoring portion of the access device from the wall of the opening and removing the access device from the bone; and inserting an implant into the opening.
- The devices and method discussed herein can accommodate the various MIS pedicle screw and rod systems placement. The devices and methods provide access to the pedicle and vertebral body so that bone cement (or any substances) can be delivered through a lumen or portal. Alternatively, the lumen can be used to insert a separate instrument for delivery of bone cement.
- The devices and method described herein allow for use of a guide wire or a k-wire to locate the pedicle via a MIS approach.
- The instrument's working end can expand so to accommodate pilot holes of various sizes so that the access device can be temporarily affixed within the pilot hole and securely anchored within the pedicle or vertebral body. The anchored instrument aids in the controlled and safe delivery of bone cement into the vertebral body and pedicle. The nature of the systems and devices also allow for the access device to be easily removed from the pedicle/vertebral body when the procedure is completed.
-
FIG. 1 shows a first variation of anaccess instrument 100 for use in applying cement as described herein. As shown, theaccess instrument 100 includes an inner tube located within amiddle tube 104 andouter tube 108. Theinner tube 102 can act as a working cannula to allow various instruments to be positioned therethrough. Theinner tube 102 can optionally include aramp feature 103 located at a distal end and described in detail further below. Themiddle tube 104 can optionally include a slottedfeature 106 or other structure to allow it to advance over theramp feature 103 to cause expansion of themiddle tube 104. Clearly, theramp feature 103 can include any feature that causes expansion of themiddle tube 104. Alternate variations include a middle tube that can expand (e.g., having a shape set or similar feature) that permits expansion of themiddle tube 104 as it advances without the need for aramp feature 103 on the inner tube. Theaccess device 100 can also include anactuation mechanism 110 that shuttles the middle tube in a distal/proximal direction. Thedevice 100 can also include a stylet knob coupled to a removable cannulatedstylet 116. Thestylet 116 can optionally include features to allow the stylet to advance over a k-wire. -
FIGS. 2A to 2C illustrate the working end of theaccess device 100 shown inFIG. 1 .FIG. 2A illustrates theinner tube 102 having alumen 118 that allows it to function as a working cannula. As shown, thestylet 116 is positioned through thelumen 118.FIG. 2A shows the working end or theaccess device 100 in an unexpanded state where themiddle tube 106 is advanced out of theouter tube 108 prior to expansion over theramp feature 103. -
FIG. 2B shows the state of theaccess device 100 where the cannulatedstylet 116 is withdrawn or otherwise removed, from thelumen 118 to allow for additional devices to he advanced therethrough or to allow fur delivery of bone cement through theaccess device 100.FIG. 2C shows the state of thedevice 100 where the middle tube 105 is actuated to advance in a distal direction over theramp feature 103 of the inner tube. Because themiddle tube 104 includes one ormore slots 106, the distal portion of themiddle tube 104 expands as shown as it advances over theramp feature 103. After or during the procedure, a physician can withdraw themiddle tube 104 by causing proximal movement. As themiddle tube 104 is moved proximally away from theramp feature 103, the expanded portion of themiddle tube 104 begins to assume its reduced profile. The proximal movement of themiddle tube 104 within theouter tube 108 causes the slotted section of the middle tube to further collapse. -
FIGS. 2D and 2E show additional variations of ramp type features 103 on thedevice 100.FIG. 2D illustrates collar placed about theinner member 102. Thecollar 103 can have a rounded proximal end to allow the slottedportion 104 to expand or diverge when advanced relative to the collar.FIG. 2E illustrates a number ofprotrusions 103 forming the ramp feature. Any number of ramp features 103 can be used in the device. -
FIG. 3A shows a cross sectional view of theaccess device 100 shown inFIG. 1 to illustrate the mechanism that permits advancement and retraction of the middle tube. As shown, thehandle 112 includes a shuttle mechanism 110 (e.g., a knob) that is in threaded engagement with a threadedhub 120. The threadedhub 120 is attached to or otherwise affixed to themiddle tube 104. Accordingly, theshuttle mechanism 110 can translate themiddle tube 104 in either a distal or proximal direction through movement of the threadedhub 120. In one variation, the threaded hub can be keyed into the handle such that it prevents rotational movement of the hub relative to the handle. Such keyed feature can be mating flats between handle and hub, or pin in a slot. - The
handle 112 also includes an anchoringstructure 122 that is attached to theinner tube 102 that prevents theinner tube 102 from moving as themiddle tube 104 advances in a distal direction over the ramp feature. Thehandle 112 can also include an outertube anchoring structure 124 at one or more points as shown inFIG. 3A . Again, the anchoringstructure 124 prevents movement of theouter tube 108 as themiddle tube 104 translates in a distal/proximal direction.FIG. 3A also illustrates a threaded cap orknob 114 that is affixed to thestylet 116, This threadedknob 114 can be affixed or attached to thestylet 116 so that thestylet 116 can be removed from thedevice 100.FIG. 3B shows a variation of the device with theshuffle mechanism 110 coupled to theouter member 108. In such a case, the inner member and intermediate member can he coupled to the handle. -
FIG. 4 shows another variation of anaccess device 100. In this variation, theaccess device 100 includes aninner tube 102 that functions as a working cannula that can deliver various instruments or cement through itslumen 118. Theinner tube 102 is housed within a middle tube (not shown inFIG. 4 ) that is located withinouter tube 108. In this variation, theouter tube 108 can be actuated using ashuttle mechanism 110. As with the devices described above, theaccess device 100 can also include a removable cannulatedstylet 116 within thelumen 118 of theinner tube 102. -
FIG. 5 illustrates a state of thedevice 100 ofFIG. 4 where thestylet knob 114 can he removed from thedevice 100. In certain variations thestylet knob 114 is internally threaded to engage a threadedfitting 126 on thehandle 112. As shown, removal of thestylet knob 114 permits removal of thestylet 116 from thedevice 100. Once removed, thedevice 100 can be coupled to any number of cement deployment systems, including those provided by DFine, Inc., San Jose, Calif. -
FIGS. 6A and 6B illustrate the state of theaccess device 100 ofFIG. 4 where theshuttle knob 110 is used to withdraw theouter tube 108. As shown, themiddle tube 104 includes one or moreexpandable section 128 that, when unconstrained by theinner tube 108, expand as shown.FIG. 6B illustrates a magnified view of the working end ofFIG. 6A , where thestylet 116 is still positioned within theinner tube 102 and theouter tube 108 moves proximally to release the constraint of theexpandable sections 128 of themiddle tube 104. When finished with the procedure, theknob 110 can be used to extend theouter tube 108 over theexpandable section 128 or tines of themiddle tube 104. -
FIG. 7 shows another variation of a working end of a device. In this example theinner tube 102 can be used to cause expansion of an expandable section 130 (in this variation expandable tines) on amiddle tube 104. As shown, theinner tube 102 is affixed to an expandablemiddle tube 104 so that proximal and distal movement of theinner tube 102 cause respective expansion and contraction of theexpandable section 130 of themiddle tube 104. However, the systems and devices described herein can he used in any situation where the application of bone cement or another substance is required. -
FIGS. 8A to 8K illustrate an example of a surgical technique to apply bone cement to a site where the bone cement assists in anchoring of an implant such as a pedicle screw. -
FIG. 8A illustrates avertebral body 200 with apilot hole 202 in apedicle 204 created by a physician in preparation for placement of a pedicle screw system. Next.FIG. 8B shows a guide wire 206 (e.g., a 1.5 mm guide wire) placed in thepilot hole 202 using a typically preferred instrument exchange method.FIG. 8C shows anaccess device 100 as described herein advanced over theguide wire 206 so that the working end of theaccess device 100 enters thepilot hole 202.FIG. 8C illustrates the distal end of theguide wire 206 extending into the cavity of thepilot hole 202. -
FIG. 8D shows a magnified view of the working end of the access device located within thecavity 210 of the pilot hole. When thedevice 100 is properly positioned in the desired anterior or posterior location, the physician can deploy theexpandable section 128 so that there is a tight fit between the walls of thepilot hole cavity 210 and theexpandable section 128 of theaccess instrument 100. As shown inFIG. 8E , this tight fit secures theaccess instrument 100 to the pedicle and/or vertebral body. -
FIG. 8F shows theaccess device 100 secured to the vertebral body where the guidewire and stylet are removed. As mentioned above, the lumen of the inner tube creates an access path into thecavity 210 of thepilot hole 202. Next, as shown inFIG. 8G , a source ofbone cement 230 can be temporarily affixed to thehandle 112 of the access device 100 (e.g., by coupling to the threadedfitting 126 discussed above. The physician can then deliver the desired amount of bone cement or other substance into thecavity 210 of thepilot hole 202. - After a sufficient amount of cement is positioned into the cavity, the physician removes the source of the cement from
access device 100 and inserts aguide wire 212 into the lumen of theaccess device 100 where the guidewire is advanced into the hone cement in thecavity 210. -
FIGS. 8I and 8J show a magnified view of thecavity 210 havingbone cement 232 located therein. As shown inFIG. 8I theexpandable section 128 of themiddle tube 204 is still secured to the walls of thecavity 210.FIG. 8J shows the state of thedevice 100 after the expandable section is retracted as discussed above. -
FIG. 8K shows the state of the procedure where theaccess device 100 is removed from thevertebral body 200 andpilot hole 202 leaving the bone cement (not shown) still within the cavity. Theguidewire 212 can remain within thepilot hole 202 to allow for placement of a pedicle screw using preferred minimally invasive surgical techniques. -
FIG. 8L illustrates a state of the lower portion of a vertebral column where the devices, methods and processes described herein provided cement to a number of sites within various structures in the vertebral column. As shown, implants, such as pedicle screws 180 placed within the hole (not shown inFIG. 8L ) so that ultimatelyrods 184 and otherimplant supporting devices 182 can be positioned as needed. It is noted that the devices, methods, and processes described, herein can be used for treatment of a vertebral pedicle. However, the devices, methods, and processes can be used tor any bone structure in the vertebral column such as thepedicle 204,vertebral body 207,sacrum 205 or even the coccyx 209. - The above and other features of the invention including various novel details of construction and combinations of parts, and other advantages, are described with reference to the accompanying drawings and the claims. It will be understood that the particular method and device embodying the invention are shown by way of illustration and not as a limitation of the invention. The principles and features of this invention may he employed in various and numerous embodiments without departing from the scope of the invention. Combination of aspects of the various embodiments or combinations of the various embodiments described herein are within the scope of this disclosure.
Claims (22)
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
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US13/841,380 US9918766B2 (en) | 2012-12-12 | 2013-03-15 | Devices, methods and systems for affixing an access device to a vertebral body for the insertion of bone cement |
EP13862396.2A EP2931144B1 (en) | 2012-12-12 | 2013-12-12 | Devices and systems for affixing an access device to a vertebral body for the insertion of bone cement |
PCT/US2013/074760 WO2014093673A1 (en) | 2012-12-12 | 2013-12-12 | Devices, methods and systems for affixing an access device to a vertebral body for the insertion of bone cement |
HK16102005.1A HK1214110A1 (en) | 2012-12-12 | 2016-02-23 | Devices, methods and systems for affixing an access device to a vertebral body for the insertion of bone cement |
Applications Claiming Priority (2)
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US201261736522P | 2012-12-12 | 2012-12-12 | |
US13/841,380 US9918766B2 (en) | 2012-12-12 | 2013-03-15 | Devices, methods and systems for affixing an access device to a vertebral body for the insertion of bone cement |
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US20140163566A1 true US20140163566A1 (en) | 2014-06-12 |
US9918766B2 US9918766B2 (en) | 2018-03-20 |
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US13/841,380 Active 2035-12-07 US9918766B2 (en) | 2012-12-12 | 2013-03-15 | Devices, methods and systems for affixing an access device to a vertebral body for the insertion of bone cement |
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US (1) | US9918766B2 (en) |
EP (1) | EP2931144B1 (en) |
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US10058336B2 (en) | 2010-04-08 | 2018-08-28 | Dfine, Inc. | System for use in treatment of vertebral fractures |
US10463380B2 (en) | 2016-12-09 | 2019-11-05 | Dfine, Inc. | Medical devices for treating hard tissues and related methods |
US10478241B2 (en) | 2016-10-27 | 2019-11-19 | Merit Medical Systems, Inc. | Articulating osteotome with cement delivery channel |
US10660656B2 (en) | 2017-01-06 | 2020-05-26 | Dfine, Inc. | Osteotome with a distal portion for simultaneous advancement and articulation |
US11026744B2 (en) | 2016-11-28 | 2021-06-08 | Dfine, Inc. | Tumor ablation devices and related methods |
US11052237B2 (en) | 2016-11-22 | 2021-07-06 | Dfine, Inc. | Swivel hub |
US11197681B2 (en) | 2009-05-20 | 2021-12-14 | Merit Medical Systems, Inc. | Steerable curvable vertebroplasty drill |
US11510723B2 (en) | 2018-11-08 | 2022-11-29 | Dfine, Inc. | Tumor ablation device and related systems and methods |
US11660134B2 (en) | 2019-06-13 | 2023-05-30 | Medos International Sarl | Instruments and methods for delivering bone cement to a bone screw |
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Also Published As
Publication number | Publication date |
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EP2931144A4 (en) | 2016-10-26 |
HK1214110A1 (en) | 2016-07-22 |
WO2014093673A1 (en) | 2014-06-19 |
EP2931144A1 (en) | 2015-10-21 |
EP2931144B1 (en) | 2020-10-07 |
US9918766B2 (en) | 2018-03-20 |
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